PB2408: PREVALENCE OF METABOLIC SYNDROME IN LONG TERM HEMATOPOIETIC STEM CELL TRANSPLANTATION SURVIVORS: COMPARISON WITH A MATCHED REFERENCE COHORT.
Authors: Nicole van Yperen, M. van Greevenbroek, B. Wauben, M. van der Poel, H. Schouten
Journal: HemaSphere (2023)

Topic: 22. Stem cell transplantation - Clinical Background: The number of hematopoietic stem cell transplantation (HCT) procedures is rising, leading to a growing population of long-term survivors. This group is reported to have a higher chance to develop the metabolic syndrome, making this population prone to cardiovascular disease. However, many previous studies on this subject were done in childhood survivors of HCT whilst many current HCT survivors were transplanted in adulthood. Also, few studies use a matched reference cohort.. Aims: To investigate the prevalence of the metabolic syndrome in long term HCT survivors who were transplanted in adulthood compared to a matched reference cohort Methods: The ‘Maastricht Observational study of late effects after Stem cell trAnsplantation’ (MOSA) is a matched cohort study, investigating long term adverse health effects in HCT survivors. A reference cohort matched on age, gender and educational level, selected from a large population based cohort, The Maastricht Study, was used as general population comparator. All patients aged 18 years or older who have undergone hematopoietic stem cell transplantation at Maastricht University Medical Centre (MUMC) and survived more than two years after transplant without evidence of active disease were invited to participate in the MOSA study. The HCT survivor population was matched to the reference cohort on age, gender and education. Metabolic syndrome prevalence was assessed using univariate and multivariate logistic regression. The analyses were adjusted for a number of covariates including smoking, alcohol consumption, physical activity and diet. Results: Metabolic syndrome criteria were evaluated in 123 stem cell transplantation survivors and 492 participants in the reference cohort. The prevalence of metabolic syndrome was n=31 (25.6%) in HCT survivors and n=140 (28.5%) in the reference cohort. HCT survivors did have fewer CVD risk factors compared to the reference cohort. This group was less likely to be current or former smokers (54% versus 67%, P=0.019), had less high frequent alcohol consumption (14% versus 28%, P=0.003) and a lower mean Body Mass Index (24.8 versus 26.4, P<.001). Calculated fat percentage was not different between the two groups (31.8% versus 32.5%, P=0.350). Analyses adjusted for covariates did not show a difference in metabolic syndrome prevalence between the HCT survivors and the reference population (OR 0.87 95% CI [0.50-1.50]). Summary/Conclusion: In this study, HCT survivors had fewer classic risk factors for cardiovascular disease (CVD) compared to a matched reference cohort representing the general population. However, stem cell transplantation survivors showed the same metabolic syndrome prevalence. The significantly lower BMI in the HCT survivors, without a corresponding lower fat percentage, suggests that this population is more prone to sarcopenic obesity. These results imply that for the long-term follow-up of HCT patients, alongside the classic CVD risk factors, other risk factors like sarcopenic obesity should be considered as well. Keywords: Stem cell transplant, Long-term follow-up, Metabolic syndrome